We are used to seeing a few different ways in which the elderly in need are cared for. In most cases, especially when the need for care is minor (my grandfather cannot do his own groceries, as the shop is far away from his place and he finds it difficult to walk), it is the family who provide the care. We are so used to this type of care that we rarely think of it as such, let alone classify it as an economic activity in terms of social reproduction. I other cases, when the need for care is more than what the family could provide, there exist various facilities nowadays. From private to semi-public and pubic, different actors come together and provide elderly care. In rarer cases, there exist voluntary, society-based organisations functioning for providing elderly care. All these types of care provision form what I call an elderly care regime. But how do such regimes form and what factors make them develop in different ways?
Bulgaria is currently undergoing a change in its elderly care regime. Who cares for the Bulgarian elderly is a very relevant question nowadays. But to get to that question now, we need to take a look at the development of the country’s elderly care regime in the past hundred and fifty years. A lot of enrooted systems still remain in the Bulgarian society, making it difficult for the elderly care regime to be easily altered (and arguably improved) by processes such as deinstitutionalisation, for example.
After gaining its independence from the Ottoman Empire in the late 19th century, like many other countries, Bulgaria had a primarily traditional society. Small-scale agricultural activities and village communities comprised the socio-economic landscape in Bulgaria. With no state support for any type of elderly care, the elderly in need were dependent on a well-developed network of care provision organised by fellow villagers. Following the massive urbanisation in the beginning of the 20th century and the disruption of community-based care, there emerged various organisations which stepped in to fill the vacuum created by the newly emerging economy.
Familial reproductive labour, together with religious and charity organisations (such as the Bulgarian Orthodox Church and the Bulgarian Association of the Red Cross), formed the elderly care regime at that time. On top of that, wealthier families could at times afford the popular then servant labour, which was also primarily used for reproductive activities. It goes without saying that in such a traditional society it was primarily women who were responsible for social reproductive activities. Elderly care was then hardly economised and very informal, all in the hands of women in pre-socialist Bulgaria.
With the consolidation of the socialist rule in the late 1940s, the socio-economic landscape in the country was significantly altered. With a highly present state in all realms of life, as well as the integration of all people in the labour force, the state needed to step into the elderly care regime too. The logic was simple – there was need for labour. Everyone needed to be integrated into the state-led economy, women included. These women, however, were responsible for taking care of the household, providing care for children and the elderly. The state could not expect from them to simply join the labour force, especially with the withdrawal of the religious organisations providing care (knowing the socialist state’s position on religion).
The solution – ‘free’ women from their social reproductive activities by founding public facilities that would ‘relieve’ them from their social reproductive work. This is when state-funded public kindergartens, schools, care facilities of all kinds emerged, significantly altering the elderly care regime as well. Although the focus of this practice was childcare, elderly care facilities were established too. This way public institutional elderly care found its way into the developing regime. Yet, this did not ‘relieve’ the woman from her familial responsibilities, rooted in traditional norms, and she continued being a mother, carer, socialist activist and worker at the same time. In the years of socialist rule, then, the elderly care regime was simply a combination of publicly provided institutional care and familial care. (Such was the case in many other Eastern European states, going through socialist changes simultaneously.)
With the fall of the socialist state, state support for care facilities was drastically reduced. Social reproductive activities were once again the responsibility of families, women, of course, being in the centre of that. With the woman already integrated in the labour force, though, she had to be everywhere. Participate in the economy as an equal-rights labourer because of the socialist integration, but also be the driving force behind social reproduction activities, such as care for the children and the elderly, and all others, because of the enrooted traditional norms. This once again shifted the elderly care regime. A shift after which familial care, primarily provided by women, dominated.
In the beginning of the new millennium and with the neoliberal turn in Bulgaria, yet another change could be observed. Pushed for by the overarching politico-economic shift in the EU and some international institutions (such as the IMF), the Bulgarian state once again entered the social realm. This time, it was the state’s role to enhance economic development and growth, and in its attempts to do that, it aimed to develop its human capital. Adopting practices to support social reproductive activities then revolved around care provision for the ones that would be considered beneficial for the economy at some point – human capital; – mainly children and the unemployed. Yet, elderly care remained somewhere on the fringes of the politico-economic.
While some state-supported elderly care facilities remained in Bulgaria, the focus of state-supported social reproductive activities remained limited to supporting the development of human capital. Even though this could be understood as acknowledgement for the vitality of social reproductive activities to the politico-economic, elderly care as such remained in the hands of the family, or the remainder of state-supported institutions for such care provision.
More recently, with the process of deinstitutionalisation, elderly care has received some attention. In the case of Bulgaria, this has translated into yet another elderly care regime. A regime that is yet to develop, bringing changes to the answers of the question who cares for the elderly? Is elderly care within the newly emerging regime once again hidden from the politico-economic, or is it being acknowledged as an important economic activity? I discuss this in the article to follow.
